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We are excited to announce our webinar with FAHP. We look forward to discussing our solution for the unable to contact population on October 26th @ 10 am EST.

Best Foot Forward Launches All-New Call Center to Further Enhance Its Superior Phone-Based Engagement Services

MONDAY, MAY 3, 2021 – Best Foot Forward (BFF), a health resource management firm specializing in helping government-insured managed care health plans, announced today the opening of a brand-new Call Center to expand and enhance its already successful engagement services. The Call Center, located in Hillside, Illinois, about 15 miles west of Chicago, is operated by Best Foot Forward Solution Services (BFFSS), a division of Best Foot Forward Sales. The new larger Call Center will once again bring team members back (from working remotely from home because of COVID) into one centralized location.

“We couldn’t be more pleased with this new larger Cook County facility, as we outgrew our last space,” explains BFFSS President Lennette Roberts. “This new space allows us the room to consolidate the entire team into one prime location for more efficient, centralized calling. The move also offers us easier access, room to grow, improved infrastructure, and enhanced IT security — as we work to ‘Locate, Educate, and Engage’.”

Best Foot Forward’s mission is to assist healthcare organizations and government-insurance payors to first locate, re-establish contact, and then connect them to their new members; or with their hard-to-reach, high-utilization, or target-risk group members. BFF is known within the industry for having a best-in-class success rate of 50% in reconnecting to what is referred to as ‘Unable to Contact’ members.

With an industry standard for Medicaid payors not being able to contact some 30% to 60% of their enrollees, Best Foot Forward provides a valuable fix that helps plan members better utilize their existing insurance coverage, thus improving plans’ health outcomes as well as addressing quality gaps as measured by HEDIS scores and other state and federal performance metrics. BFF carefully customizes and designs health engagement solutions and phone-based strategies to help health plans meet key targets and enhance member communication, patient education, and financial goals. These efforts also help reduce the gaps in care experienced by minority members.

“Our new Call Center will allow us more streamlined and enhanced internal collaboration,” explains BFF Co-CEO Byron Dennis. “This new facility along with our highly-effective location tools and phone-based strategies will surely result in higher engagement rates. With the opening of our new Center today, we begin a new, exciting era for Best Foot Forward.”

ABOUT BFF
Best Foot Forward (BFF), a certified minority-owned business, is headquartered in South Florida, with offices in Illinois, Indiana, Ohio and Pennsylvania. BFF’s mission is to provide integrated programs using insight-driven solutions that focus on delivering a clear process to connect, communicate, and assist managed care members and plan providers. www.bestfoodforwardsales.com

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Best Foot Forward (BFF), a health resource management firm specializing in member engagement services, is proud to announce its recent affiliation as a new member/partner/business associate with two leading national healthcare associations — Medicaid Health Plans of America (MHPA) and as a Preferred Vendor with the Association for Community Affiliated Plans (ACAP). MHPA represents the interests of the Medicaid managed care industry through advocacy and research to support innovative policies that enhance the delivery of comprehensive, cost-effective, and quality healthcare for Medicaid enrollees; ACAP represents health plans that service their members through Medicaid, Medicare, and Children’s Health Insurance Program (CHIP) and collectively provide health coverage to more than 20 million people.

“Best Foot Forward is thrilled to become members of both these exceptional organizations and looks forward to becoming active participants,” explains Byron C. Dennis, co-CEO/partner of Best Foot Forward. “Our company works with health care organizations — primarily government insurance Managed Care health plans — to help them re-establish contact with existing members and connect with new members, hard-to-reach, high-utilization, or target-risk group enrollees. Because MHPA and ACAP provide so much valuable assistance in helping their health plan members better serve Medicaid beneficiaries, this is just a perfect fit for us. We’re honored to work together for common goals.”

Founded in 2009, Best Foot Forward provides quality and comprehensive member engagement services for today’s MCOs. Headquartered in South Florida, with offices in Illinois, Indiana, Ohio and Pennsylvania, BFF uses its innovative “Locate, Educate and Engage” approach to help identify and then reconnect managed care members with plan providers.

With an industry standard of Medicaid payors not being able to contact some 30% to 60% of their members, BFF provides a true fix that helps address quality gaps measured by HEDIS scores and other state and federal performance metrics.
“At Best Foot Forward, we fully understand that when insurance providers are unable to make contact with a significant portion of their Medicaid/Medicare member population, then they’re unable to offer their services and improve health outcomes,” explains Dennis. “To resolve this, we have designed a comprehensive strategy that encompasses an amazing assortment of tools that garners unprecedented results at affordable prices. On average, we engage over 50% of the assigned members. No other firm can make those types of substantiated claims.”

“The simple fact is that health plans can’t manage their members’ care without engaging with them,” states Rich Dudley, Best Foot Forward’s other co-CEO/Partner. “We have a notable and successful track record of locating and engaging with health plan members. BFF enables the fulfilment of the managed care vision.”

ABOUT BFF
Best Foot Forward (BFF), a certified minority-owned business, is headquartered in South Florida, with offices in Illinois, Indiana and Pennsylvania. BFF’s mission is to provide integrated programs using insight-driven solutions that focus on delivering a clear process to connect, communicate, and assist managed care members and plan providers. www.bestfoodforwardsales.com

Over 13 million children in the U.S. have special health care needs, and Medicaid plays an important role in ensuring these children get the care that they need to improve their health and their quality of life.

Children and youth with special health care needs (CYSHCN) are those who “have or are at increased risk for chronic physical, developmental, behavioral, or emotional conditions and also require health and related services of a type or amount beyond that required by children generally” as defined by the American Academy of Pediatrics (AAP). 

Medicaid and the Children’s Health Insurance Program (CHIP) cover about half of CYSHCN who require medical and long-term care services due to intellectual or developmental disabilities, physical disabilities, and/or mental health disabilities. 

Medicaid makes health care coverage affordable for these children and their families. Most of these children live in low- or middle-income families. Some CYSHCN qualify for Medicaid based solely on their family’s low income, and others qualify for Medicaid through a disability-related pathway. 

States can also allow CYSHCN in middle income families to “buy in” to Medicaid to get the care that they need by covering services that are not included under private insurance and by making coverage affordable. 

Most CYSHCN are school-aged, with just over one in five being five years old or younger, and many require additional help or therapy at school. Medicaid helps by supplementing special education services and by providing therapy through special education at school. Medicaid also covers additional therapies necessary for a child to function at home and in their community. 

Children with higher level needs can get coverage for physical and behavioral health services and long-term services and supports that keep them living at home with their families. Many of these services are either not covered or are only available in limited amounts through private insurance. 

Health plans play an important role in helping CYSHCN and their families, including two services that are essential to ensuring these families get quality care.

Assign a Primary Care Provider

The AAP recommends that pediatricians play a leadership role in ensuring CYSHCN get the care they need. Their recommendations include:

• Promoting health and wellness and timely assessments of child social-emotional health, parental and/or caregiver depression, and social determinants of health.
• Preparing pediatric practices to improve screening, referrals, and follow-up of these children to ensure they receive the care they need.
• Working with child care and school staff to monitor progress, reduce absences, and improve learning experiences and academic performance.
• Advocating for community-based resources and strategies to address social determinants of health and reduction of disparities for children with health issues and their families.

Ensuring CYSHCN families are assigned to a provider they feel comfortable with and see regularly is an important component of their care.

Provide Care Management

Care management can provide an additional level of support to these children and their families to help them navigate complex systems and ensure they get the care they need to grow into the most productive and healthy people they can be.

A few years ago, The Department of Health and Human Services declared the opioid crisis to be a public health emergency (PHE). Amid addressing the challenges of that PHE, the COVID-19 pandemic came to the doorstep and presented another challenge, which has exacerbated issues for those struggling with substance abuse and the professionals who are trying to provide treatment. EHS Today reported, “Public health officials across the country are reporting spikes in drug overdose deaths during the COVID-19 pandemic, with more than 30 states reporting increases in opioid-involved overdose deaths.”

To complicate matters, individuals struggling with substance abuse and addiction are at higher risk for COVID-19 infection and complications, raising the importance of addressing both diseases.

In response to the pandemic, treatment programs have integrated telehealth technology for services they typically offer in person, including individual and group counseling, psychiatric services, support groups, and new patient admissions. 

Many treatment programs have faced the same challenges in the integration of telehealth that have been faced by other health care providers. There have been technology challenges, some patients lack access to technology or the skills to use it, and there can be complicated logistical problems to figure out.

Despite the start-up challenges, telehealth has resulted in some promising outcomes for treatment programs. 

For one, telehealth offers a solution for reaching patients who would otherwise experience a barrier to care. This is especially true for patients in rural areas. Previously, getting medication for the treatment of opioid addiction required an in-person appointment. However, “forty percent of counties in the U.S. do not have a single health care provider with a waiver permitting them to prescribe the opioid addiction treatment drug buprenorphine in an office setting,” according to an Office of Inspector General (OIG) report. Telehealth offers a solution for those patients.

There are also anecdotal examples of the benefits of telehealth for the treatment of substance abuse. 

• An Office of Inspector General (OIG) report shared a quote from a treatment program official saying, “Our no-show rate is non-existent because of telehealth. We have bus and transportation issues when the weather is bad, but with telehealth, it is not an issue. The verbal feedback from patients is 100-percent satisfaction.”
• The OIG report also shared, “One treatment program found that patients were more willing to participate in an hour-long conversation over the phone than they were to come to the facility for an hour-long meeting.”

The advances in telehealth use are essential not only for the treatment of substance abuse but also for the treatment of comorbidities that are often connected with addiction. Substance abuse puts individuals at greater risk of multiple health issues, including:

• Mental illness
• Chronic pain
• Cancer
• Heart disease
• Tobacco use
• Infectious disease (e.g., hepatitis C)
• HIV

It is important to take the lessons from this period of time to continue to leverage telehealth to break down barriers to access and deliver high-quality substance abuse treatment in the future.

Many health plans put an emphasis on assigning members to a primary care provider. It may, however, be a good practice to invest the time to match members with the right primary care provider, so the members are motivated to see the same provider consistently. 

The study entitled The Medical Home, Access to Care, and Insurance: A Review of Evidence states, “International and within-nation studies indicate that a relationship with a medical home is associated with better health, on both the individual and population levels, with lower overall costs of care and with reductions in disparities in health between socially disadvantaged subpopulations and more socially advantaged populations.”

Better Health

Members who have a PCP have been shown to have better health outcomes than members who do not consistently see the same PCP. 

One study, The Role of Provider Continuity in Preventing Hospitalizations, showed that patients with better provider continuity for one year had significantly lower rates of hospitalization in the subsequent year.

Providers are better able to assess a patient’s risks, needs, and condition when they have knowledge of their medical history. Consistency also allows for increased trust and better communication in the doctor-patient relationship.

There is also evidence that suggests that patients are more likely to follow medical recommendations and are more satisfied with their care when they have a consistent PCP.

Lower Costs

According to the report, Provider Continuity in Family Medicine: Does It Make a Difference for Total Health Care Costs? Provider continuity with a family physician was, indeed, one of the most important variables related to the total health care cost. 

The report explains, “Looking at the individual behavior of patients, a study reviewing all claims of a random sample of Medicaid patients (aged 0 to 21 years) for 3 years showed that continuity with the same practitioner was associated with a significant reduction in the number of hospital admissions and overall costs.”

Another study, The Role of Provider Continuity in Preventing Hospitalizations, showed that continuity of care with a provider is associated with a decrease in the likelihood of hospitalization for the study group. 

Reduction in Health Disparities

Yet another study, Insurance or a regular physician: Which is the Most Powerful Predictor of Health Care?, pointed to the ways in which a consistent PCP can reduce health disparities. “Lack of a regular physician is a stronger, more consistent independent predictor than insurance status of each of our 3 measures of poor access to care: delay in seeking emergency care, no physician visits in the previous year, and no emergency department visits in the previous year.”

Assigning members to PCPs has long been a priority for health plans and, anecdotally, has been accepted as a best practice. However, the research is there to back the practice up. Members who have an assigned PCP are more likely to be in better health, result in lower health care costs, and experience a reduction in health care disparities.  

Chronic disease is the leading driver of the United States’ $3.5 trillion in annual health care costs. More than 80 percent of Medicaid’s expenditures are spent on adults with chronic conditions. Chronic diseases are not only expensive, but they are also pervasive. About 60% of adults in the US have a chronic condition.

Managing care for this population is essential but difficult. The Medicaid Value Program: Health Supports for Consumers with Chronic Conditions, an initiative designed by the Center for Health Care Strategies, Inc. and funded by Kaiser Permanente and the Robert Wood Johnson Foundation, set out to find innovative ways to improve care delivery for Medicaid recipients with multiple chronic conditions. 

Through their case studies, lessons can be learned, and innovation can be sparked to help find ways to improve health outcomes and reduce unnecessary health incidences and costs. Here is a summary of some of the approaches taken.

Address Social Determinants of Health 

The Care Oregon Complex Care Support Program

 This program aimed to expand and leverage care management to address factors that hinder proper care for members with chronic conditions. This included addressing mental health needs, but it also expanded to include addressing social issues, such as housing insecurity, substance abuse and addiction, and lack of social support systems. 

Integrate House Calls 

District of Columbia Department of Health, Medical Assistance Administration

 This initiative used the Medical House Call Program to assist chronically ill seniors. The program would make home visits to provide case management and to coordinate care. By providing in-home visits, the program aims to reduce end-of-life hospitalizations, hospital lengths of stay, emergency room visits, and nursing home placements.

Address Mental and Behavioral Health Care Needs

Johns Hopkins HealthCare LLC

 This program expanded care management for Medicaid beneficiaries with both chronic illness and mental health or substance abuse. This included helping patients with care integration, self-management, and referrals to community resources. 

Targeting Case Management

Managed Health Services, Inc.

 This project tested predictive modeling and health risk assessment screenings to determine how to improve the case management of consumers with multiple chronic conditions. They also studied the relationship between case management and hospitalizations, and emergency room utilization.

Improve Health Education 

McKesson Health Solutions

 This project looked at the effectiveness of diabetes group education for aged, blind, and disabled Medicaid consumers. 

Utilize a Health Care Navigator

Memorial Healthcare System

 Most Valued Partner (MVP) Program integrated a Health Navigator into the disease management team to develop care plans based on each individual patient’s needs. They also addressed barriers to care, referrals to community resources, and encouraged other productive behaviors.

Integrate Care

Washington State Department of Social and Health Services

 The program integrated primary care, mental health, substance abuse services, long-term care, and disease management for the target population using intensive and ongoing case management services. 

Improving outcomes for patients with chronic disease is a monumental undertaking that requires innovation, as represented in these case studies. 

At the start of the pandemic, The Centers for Medicare and Medicaid Services (CMS) quickly passed emergency measures to allow flexibility for the medical community to adapt to the public health emergency (PHE) and to ensure they were able to deliver care effectively and safely. That resulted in a rapid expansion of telehealth, which has been well received by patients and providers alike.

As we look toward 2021 and to the hopes for the end of the COVID-19 pandemic, CMS has released guidelines for telehealth coverage post-pandemic.

Telehealth Services That Will Remain Permanent

These services are scheduled to become permanent effective January 1, 2021.

• Group Psychotherapy
• Domiciliary, Rest Home, or Custodial Care Services for Established Patients
• Home Visits for Established Patients
• Cognitive Assessment and Care Planning Services
• Visit Complexity Inherent to Certain Office/Outpatient E/MS
• Prolonged Services
• Psychological and Neuropsychological Testing

Telehealth Services That Will Be Removed

These services will be removed when the PHE expires.

• Initial nursing facility visits for all levels
• Psychological and Neuropsychological Testing
• Therapy Services, Physical and Occupational Therapy for all levels
• Initial hospital care and hospital discharge day management
• Inpatient Neonatal and Pediatric Critical Care, Initial and Subsequent
• Initial and Continuing Neonatal Intensive Care Services
• Critical Care Services
• End-Stage Renal Disease Monthly Capitation Payment
• Radiation Treatment Management Services
• Emergency Department Visits, Levels 4-5
• Domiciliary, Rest Home, or Custodial Care services for new patients
• Home Visits for new patients, all levels
• Initial and Subsequent Observation and Observation Discharge
• Day Management

Telehealth Services, Requesting Comment

CMS is not currently proposing to add these services to the Medicare telehealth services list. They are, however, seeking comment on whether these services should be added. When considering the comments, CMS will assess whether there are increased concerns for patient safety if the services is delivered via telehealth, whether there are concerns about jeopardizing the quality of care if delivered via telehealth; and whether all elements of the service could be performed using telehealth.

• Initial nursing facility visits for all levels
• Psychological and Neuropsychological Testing
• Therapy Services, Physical and Occupational Therapy for all levels
• Initial hospital care and hospital discharge day management
• Initial and Subsequent Inpatient Neonatal and Pediatric Critical Care
• Initial and Continuing Neonatal Intensive Care Services
• Critical Care Services
• End-Stage Renal Disease Monthly Capitation Payment
• Radiation Treatment Management Services
• Emergency Department Visits, Levels 4-5
• Domiciliary, Rest Home, or Custodial Care services, New
• Home Visits, New Patient for all levels  
• Initial and Subsequent Observation and Observation Discharge Day Management

To learn more about the services that will be covered, refer to the 2021 Physician Fee Schedule.

Additionally, an Executive Order on Improving Rural Health and Telehealth Access was released, which may result in continued and increased access to telehealth services for the 57 million Americans living in rural communities. The order has launched reports on:

• A new payment model to ensure rural providers can provide quality care.
• Improvements to communications infrastructure in rural communities to ensure access to care.
• Review of existing and upcoming policy initiatives to eliminate regulatory burdens that limit the availability of providers; prevent disease through efforts to improve health outcomes; reduce maternal mortality and morbidity; and improve mental health.
• Review the expansion of telehealth and flexibilities for providers during the PHE to determine if they should become permanent.

Few would argue that we are living through an extraordinarily stressful time. But how many people consider the impact that stress has on our health?

Stress has been shown to have a direct correlation to health outcomes, and managing it is important for overall wellbeing. This is especially true for the six in ten Americans already managing a chronic medical condition. Whether they have heart disease, diabetes, cancer or another chronic condition, people with chronic conditions would benefit from stress-management strategies.

When you are under stress, your body responds by releasing hormones like adrenaline and cortisol. Those hormones are important to help your body properly respond to stressful situations. However, if the stress is not alleviated and the body’s remains under stress for a long duration of time, there can be negative effects on the body. 

• Weakened Immunity
• Weight Gain
• Sleep Problems
• Heart Disease
• Anxiety and Depression
• Digestive Problems

These negative effects can compound the impact of chronic disease, but there are steps that can be taken to help patients alleviate stress.  

Encourage Exercise

Aerobic exercise has been shown in numerous studies to reduce stress, and now a study published in the Journal of the American Medical Association found that resistance training was also associated with a reduction in stress. 

Provide Referrals to Social Services

Economic Stability is recognized by the Centers for Disease Control and Prevention (CDC) as one of the social determinants of health. The pandemic has impacted employment, food security, and housing security. Referrals to social services and assistance programs can help members get the support they need and reduce the stress caused by a vulnerability in these areas. 

Suggest Safe Socialization

Relationships and interactions with friends and family are also recognized by the CDC as contributors to health. In a popular TED talk, the psychiatrist Robert Waldinger explains, “Social connections are really good for us, and loneliness kills. It turns out that people that are more socially connected to family, to friends, to the community are happier, physically healthier, and they live longer than people that are less well connected.” During this time of quarantines, lockdowns, and social distancing – when people with chronic conditions are at high risk for COVID-19 and are encouraged to be vigilant – it is important to help patients discover options for safe socialization. 

Meditation and Other Relaxation Techniques

Carnegie Mellon University conducted research that showed that 25 minutes of mindfulness meditation for three consecutive days resulted in stress reduction. With the increase in the popularity of meditation has come several free resources for beginners. Members can be directed to meditation apps like Insight Timer, podcasts, and YouTube videos to get started with a meditation practice. 

Remind Members About the Nurse Advice Line 

It can be stressful to have a health-related question and not know what to do, and that stress has been exacerbated by the pandemic. Remind members that they can always call the Nurse Advice line to get answers to their medical questions.